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Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study

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Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients : A post hoc analysis of the TTH48 study. / TTH48 Investigators.

I: Resuscitation, Bind 165, 21.06.2021, s. 85-92.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{5654e462fa4e4f3daa396615cf2b17cc,
title = "Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients: A post hoc analysis of the TTH48 study",
abstract = "BACKGROUND: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.METHODS: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the {"}quality of TTM{"}.RESULTS: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.CONCLUSIONS: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.",
author = "{De Fazio}, Chiara and Skrifvars, {Markus B} and Eldar S{\o}reide and Grejs, {Anders M} and {Di Bernardini}, Eugenio and Jeppesen, {Anni N{\o}rgaard} and Christian Storm and Jesper Kjaergaard and Timo Laitio and Rasmussen, {Bodil Sten} and Marjaana Tianen and Hans Kirkegaard and Taccone, {Fabio Silvio} and {TTH48 Investigators}",
note = "Copyright {\textcopyright} 2021 Elsevier B.V. All rights reserved.",
year = "2021",
month = jun,
day = "21",
doi = "10.1016/j.resuscitation.2021.06.007",
language = "English",
volume = "165",
pages = "85--92",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - Quality of targeted temperature management and outcome of out-of-hospital cardiac arrest patients

T2 - A post hoc analysis of the TTH48 study

AU - De Fazio, Chiara

AU - Skrifvars, Markus B

AU - Søreide, Eldar

AU - Grejs, Anders M

AU - Di Bernardini, Eugenio

AU - Jeppesen, Anni Nørgaard

AU - Storm, Christian

AU - Kjaergaard, Jesper

AU - Laitio, Timo

AU - Rasmussen, Bodil Sten

AU - Tianen, Marjaana

AU - Kirkegaard, Hans

AU - Taccone, Fabio Silvio

AU - TTH48 Investigators

N1 - Copyright © 2021 Elsevier B.V. All rights reserved.

PY - 2021/6/21

Y1 - 2021/6/21

N2 - BACKGROUND: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.METHODS: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".RESULTS: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.CONCLUSIONS: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.

AB - BACKGROUND: No data are available on the quality of targeted temperature management (TTM) provided to out-of-hospital cardiac arrest (OHCA) patients and its association with outcome.METHODS: Post hoc analysis of the TTH48 study (NCT01689077), which compared the effects of prolonged TTM at 33 °C for 48 h to standard 24-h TTM on neurologic outcome. Admission temperature, speed of cooling, rewarming rates, precision (i.e. temperature variability), overcooling and overshooting as post-cooling fever (i.e. >38.0 °C) were collected. A specific score, ranging from 1 to 9, was computed to define the "quality of TTM".RESULTS: On a total of 352 patients, most had a moderate quality of TTM (n = 217; 62% - score 4-6), while 80 (23%) patients had a low quality of TTM (score 1-3) and only 52 (16%) a high quality of TTM (score 7-9). The proportion of patients with unfavorable neurological outcome (UO; Cerebral Performance Category of 3-5 at 6 months) was similar between the different quality of TTM groups (p = 0.90). Although a shorter time from arrest to target temperature and a lower proportion of time outside the target ranges in the TTM 48-h than in the TTM 24-h group, quality of TTM was similar between groups. Also, the proportion of patients with UO was similar between the different quality of TTM groups when TTM 48-h and TTM 24-h were compared.CONCLUSIONS: In this study, high quality of TTM was provided to a small proportion of patients. However, quality of TTM was not associated with patients' outcome.

U2 - 10.1016/j.resuscitation.2021.06.007

DO - 10.1016/j.resuscitation.2021.06.007

M3 - Journal article

C2 - 34166741

VL - 165

SP - 85

EP - 92

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -